[michaelkeenan]

I'm sad that you've been downvoted, though I disagree with you.

Occupational licensing doesn't just improve service quality (if it improves service quality), it also increases the price. The result is often that instead of great quality, the consumer gets nothing at all because ze can't afford it. This hits the poorest people hardest. In the USA, the poor have a famously bad time with healthcare and legal advice.

There are mechanisms other than mandatory qualifications by which consumers can measure quality, including voluntary qualifications, reputation, and price signaling. These aren't perfect, but neither are mandatory qualifications. Each mechanism has advantages and disadvantages.

[philwelch]

With healthcare at least, there are walk-in clinics and nurse practitioners. Without licensure you wouldn't have a surfeit of cheap doctors; you'd have quacks running around representing themselves as doctors. With licensure you still have the quacks, but they call themselves "alternative medicine" and you can still go to them if you want. So there's no real loss of choice there.

[rbarooah]

Medical licensing isn't just about the right to call yourself a doctor.

Alternative medicine practicioners, or even experienced doctors who qualified in another country, are not allowed to perform the same procedures as doctors regardless of whether their patients would like them to. There is a very real loss of choice.

[philwelch]

Internationalization is a valid point, but I'm not too choked up about my witch doctor not being allowed to perform open heart surgery. Besides, he would probably rather prescribe me water or stick needles in me instead.

[rbarooah]

Sarcasm aside, you're missing the point. Why isn't it sufficient to regulate the title 'Doctor' without preventing other practitioners from practicing?

People who wanted a traditional medical practitioner would be protected, and those who were willing to take more risk would have the choice.

[vidarh]

Because it assumes there would be a real informed choice.

The staggering amount of money that do get paid to quacks selling stuff that is proven not to work show us very clearly that informed choice is largely a fantasy when dealing with the general public.

[rbarooah]

What makes you so sure things would get worse?

[philwelch]

Homeopaths and acupuncturists don't even do normal medical procedures; that's kind of the point. If you are doing normal medical procedures, you should be licensed and regulated to make sure you know what the hell you're doing. The freedom to have an unlicensed witch doctor perform open heart surgery on you isn't an essential human right; it's not even something a sane and informed person would want to do. It's a non-issue.

[rbarooah]

Mentioning witch-doctors, homeopaths and acupuncturists is a straw man.

It seems to me that that private group of scientifically grounded medical practitioners who certified their members, but had different criteria from the state licensing system could be a very good thing.

This alternate certification would need to prove its reputation just as the institutions that certify doctors have. It seems likely that there are ways to train and certify doctors that produce better professionals than the current ones.

I doubt you're arguing that current state approved medical institutions cannot be improved upon. Why not allow alternatives to compete with them?